Virtual physician office systems and methods

ABSTRACT

Electronic records are formatted according to recipient addresses. When an electronic database record is received by a server or other device, the electronic database record has any formatting, herein termed a legacy format. The electronic database record is destined for delivery to device identified by a recipient address. The recipient address is associated with a software agent that reformats the legacy format into a different format. The electronic database record is thus reformatted according to software agent associated with the recipient address. A reformatted database record is thus sent to the recipient address, and the reformatted database record has the different format.

CROSS REFERENCE TO RELATED APPLICATIONS

This application relates to applicants' co-pending U.S. patentapplication Ser. No. 10/253,500 entitled “Network-Based HealthcareInformation Systems,” (Attorney Docket 02-BS017/BS00233) filed Sep. 24,2002, and of which the “Brief Summary of the Invention” and “DetailedDescription of the Invention” sections are incorporated herein by thisreference.

This application also related to applicants' co-pending U.S. patentapplication entitled “Healthcare Virtual Private Network Methods andSystems,” (Attorney Docket 02-BS061/BS02524) filed simultaneouslyherewith, and of which the “Brief Summary of the Invention” and“Detailed Description of the Invention” sections are incorporated hereinby this reference.

NOTICE OF COPYRIGHT PROTECTION

A portion of the disclosure of this patent document and its figurescontain material subject to copyright protection. The copyright ownerhas no objection to the facsimile reproduction by anyone of the patentdocument or the patent disclosure, but the copyright owner otherwisereserves all copyrights whatsoever.

BACKGROUND OF THE INVENTION

1. Field of the Invention

This invention generally relates to computer networks and to telephony.More particularly, this invention is directed to methods and systems formore efficient and effective physician practice management of electronicdata in a network-based communications system.

2. Description of the Related Art

In Epidemics, Hippocrates wrote “[t]he art of medicine has threefactors: the disease, the patient and the physician.” Were he writingtoday, the Father of Medicine would also likely include “access tohealthcare information” as a fourth factor. Why? Because today'shealthcare marketplace is driven by increasing pressure for costcontrols, by the increased strength of the consumer voice, by a shiftfrom hospital inpatient care towards primary, ambulatory, and home care,by an emphasis on “case management,” by increased competition, and bythe focus on quality that is necessary for better patient care. Thisrelentless drive to improve efficiencies and cut costs makes manytraditional procedures inefficient. This relentless drive also presentsgreat opportunities for healthcare professionals, organizations,patients, and others to enter into new types of multi-institutionpartnerships (e.g., strategic alliances between physicians' offices,hospitals, clinics, labs, diagnostic centers, medical recordrepositories, insurers, patients, pharmaceutical and surgical suppliers,other vendors, etc.) that utilize many different computing systems andother communications technologies to manage and share electronichealthcare information. One of the biggest barriers facing thesemulti-institution partnerships is creating and maintaining anetwork-based system that manages efficient, effective, and secureaccess to standardized or otherwise compatible electronic healthcareinformation and communications (e.g., able to be presented over avariety of different software and hardware platforms).

Thousands, if not hundreds of thousands or more, of electronicdocuments, emails, and proprietary information are generated each dayand shared among these multi-institution partnerships andnon-participants. For example, a physician might order a complex labtest from the local hospital. Instead of waiting for the results toarrive by hand delivery, the physicians' office may get online andrequest the test results via secure, encrypted email. The hospital's labstaff either manually attaches the lab result to a return email, or, inmore advanced systems, the lab system responds automatically to therequest and returns the results to a legacy system accessible by thephysician. Another example is when a physician needs to admit a patientto the hospital. Instead of having the staff call the admission officeand spend upwards of thirty (30) minutes talking and waiting on hold,the office sends the pre-admission information electronically, includingpatient record information and pre-admission orders to the hospital viaan email attachment or directly to the hospital's legacy system. As usedherein, the term “legacy system” or “legacy systems” includes dataprocessing, storage, management, and information systems, communicationsdevices, and other network components, such as, for example, databasesof electronic patient health history, patient insurance information,demographic information, and physical records. Typically, each legacysystem is customized in terms of software, hardware, and networkconfiguration for each participant. Typically, each legacy systemincludes a network of multiple computer systems (e.g., personalcomputers, personal digital assistants, and other communicationsdevices); however, the legacy system may also be a stand-alone computersystem.

In the above examples, the shared electronic data may be processed in avariety of ways. For example, the hospital may provide information tothe physician by transmitting data over a Local Area Network (LAN)connection into a database on a web server. This healthcare informationcould then be transmitted to a computer system (e.g., personal computeror “PC”) of the physician office legacy system over a data connection,such as the Internet, Intranet or Extranet, or over a direct connection,such as dial up access, using push technology that automaticallybroadcasts the data to the physician's computer system and allows thephysician to view the transmitted healthcare data using an appropriatesoftware package, such as a browser, or by using an applet. Thus far,there have not been any network-based systems that facilitatestandardized and/or otherwise compatible, secure communications betweenand among multiple legacy systems and non-legacy systems (e.g., acommunications device of a non participant) as well as provide reliableserver-based network applications.

In addition to the challenges above, most of the participants andnon-participants must also comply with a variety of federal, state,local and other rules that protect the privacy and security ofhealthcare information associated with a patient. For example, theHealth Insurance Portability and Accountability Act (HIPAA), signed intolaw by President Clinton on Aug. 21, 1996 (Pub. L. 104-191, 110 Stat.1936), covers health plans, healthcare clearinghouses, and healthcareproviders who conduct certain financial and administrative transactions(e.g., electronic billing and funds transfers) electronically. Providers(e.g., physicians, hospitals, etc.) and health plans are required togive patients a clear written explanation of how a covered entity mayuse and disclose a patient's healthcare information. Further, healthcareproviders are required to obtain patient consent before sharinginformation for treatment, payment, and healthcare operations. Inaddition, HIPPA also requires that a provider adopt and implementprivacy procedures to ensure the privacy and security of the healthcareinformation.

The above discussion illustrates how the sharing and management ofhealthcare information (including communications, data, and/or otherelectronic transmissions) and technology between and among multiplecommunications devices (of participants and non-participants) iscreating a new foundation for a virtual healthcare setting. With thisemerging virtual healthcare setting, what are needed are improvednetwork-based healthcare systems and methods that integratecommunications infrastructures of each participant to build a secure,integrated, network-based system accessible by participants andnon-participants to support different organizational needs andcapitalize on emerging trends in the healthcare setting. In addition,the network-based system should provide efficient networked-basedhealthcare practice management applications that leverage the assets ofeach legacy system. Accordingly, integrated, network-based healthcaresystems and methods are needed that enable sharing, transferring,accessing, and managing standardized or otherwise compatible data andcommunications with multiple legacy systems. Further, a need exists toimprove notification, access, and management of the electronicallyshared healthcare information and communications without investingmillions of dollars in computer equipment, in a networkinginfrastructure, in maintenance, and in training while also complyingwith security, authenticity, and/or privacy requirements.

BRIEF SUMMARY OF THE INVENTION

The aforementioned problems and others arc reduced by virtual physicianoffice (“VPO”) systems and methods that provide more efficient andeffective management of electronic healthcare communications (includingaudio, video, text, and/or digital data) within a network-basedcommunications systems. The VPO leverages the assets of atelecommunications network, a data network, and/or other communicationsnetwork of a legacy system associated with each participant in amulti-institutional partnership to facilitate improved access, sharing,notification, security, and/or management of electronic healthcarecommunications. Some advantages of VPO include increased ability toflexibly manage, bill, and track physician services, faster access toelectronic healthcare communications and/or data shared among or betweenmultiple legacy systems, and increased ability to share electronichealthcare data among or between different networks of communicationsdevices. In addition, the VPO utilizes proprietary network-based systems(depending on how a physicians' office and/or a physician's homeaccesses the VPO) to reduce or prevent electronic healthcare data and/orcommunications from entering traffic in a public data network, such asthe Internet. If electronic healthcare data and/or communications arerouted over a public data network, then the VPO may utilize encryptionand/or other secure technologies to protect and keep private thecontents of the data and/or communication.

An embodiment of this invention describes a method that includesreceiving an electronic healthcare communication associated with aphysician office legacy system to a network-based communications system,categorizing the electronic healthcare communication, and using aphysician practice management application to process the electronichealthcare communication. The network-based communications systemenables an exchange of the electronic healthcare communication betweenthe physician office legacy system and one or more networks ofcommunications devices associated with a telecommunications serviceprovider. Typically, the physician practice management application runson a server associated with the network-based communications system,such as a central office (“CO”) of a public switched telecommunicationsnetwork (“PSTN”) and/or of a mobile switching center of a mobileswitching telecommunications office (“MSTO”).

Other embodiments describe methods that include establishing a firstdata connection between a communications device of a physician officelegacy system and a network-based communications system, receiving anelectronic healthcare communication from the communications device overthe data connection, accessing a physician practice managementapplication, using the physician practice management application tomanage the electronic healthcare communication, establishing a seconddata connection, and communicating the electronic healthcare data viathe first data connection and the second data connection. According toan embodiment, the second data connection is established between thenetwork-based communications system and a second legacy system.According to another embodiment, the second data connection isestablished between the network-based communications system and anon-affiliated (e.g., non-participant of the multi-institutionalpartnership) communications device. In both embodiments, the second dataconnection uses a rule-based application dataserver to categorize theelectronic healthcare into one or more of the following categories: (1)data associated with an access agent, (2) data associated with asecurity agent, (3) data associated a messaging/communications agent,(4) data associated with a transactional agent, (5) data associated witha troubleshooting agent, and (6) data associated with an applicationagent.

Still further, this invention describes a system that includes a networkof legacy systems, a physician practice management application formanaging electronic healthcare communications associated with at leastone of (i) a calendar and schedule, (ii) patient information, (iii)charges and fees, (iv) receipts, (v) laboratory testing, (vi)prescriptions, (vii) reports, (viii) office facilities and maintenance,(ix) compliance and inspections, (x) patient triage and medicalprotocols, (xi) on-call services, (xii) insurance billing and appeals,(xiii) patient billing, and (xiv) back-up storage settings, and arule-based application dataserver for managing the exchange ofelectronic healthcare data with the legacy system, the rule-basedapplication dataserver provided by the telecommunications serviceprovider.

BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWINGS

The above and other embodiments, objects, uses, advantages, and novelfeatures of this invention are more clearly understood by reference tothe following description taken in connection with the accompanyingfigures, wherein:

FIG. 1 is a schematic illustrating an overview of an exemplary operatingenvironment of a virtual physician office (VPO) according to anembodiment of this invention;

FIG. 2 is a block diagram showing of a VPO Management Module thatresides in a computer system according to an embodiment of thisinvention;

FIG. 3 is a schematic showing a detailed schematic of an operatingenvironment for a VPO system according to an embodiment of thisinvention;

FIG. 4 is a schematic showing a detailed schematic of another operativeenvironment for a VPO system according to an embodiment of thisinvention;

FIG. 5 is a detailed schematic of the VPO vile-based applicationdataserver residing in the network-based communications system shown inFIG. 1;

FIG. 6 is a detailed schematic of a VPO rule-based profile residing inthe physician office legacy system shown in FIG. 1;

FIG. 7 is a schematic showing an exemplary embodiment of communicatingan electronic healthcare communication using wired and wirelesscommunications devices associated with the VPO according to anembodiment of this invention;

FIG. 8 is a schematic showing another exemplary embodiment ofcommunicating an electronic healthcare communication using wired andwireless communications devices associated with the VPO according to anembodiment of this invention; and

FIGS. 9-11 are flowcharts showing a method of providing VPO servicesaccording to an embodiment of this invention.

DETAILED DESCRIPTION OF THE INVENTION

This invention now will be described more fully hereinafter withreference to the accompanying drawings, in which exemplary embodimentsare shown. This invention may, however, be embodied in many differentforms and should not be construed as limited to the embodiments setforth herein; rather, these embodiments are provided so that thisdisclosure will be thorough and complete, and will fully convey thescope of the invention to those of ordinary skill in the art. Moreover,all statements herein reciting embodiments of the invention, as well asspecific examples thereof, are intended to encompass both structural andfunctional equivalents thereof Additionally, it is intended that suchequivalents include both currently known equivalents as well asequivalents developed in the future (i.e., any elements developed thatperform the same function, regardless of structure).

Thus, for example, it will be appreciated by those of ordinary skill inthe art that the diagrams, schematics, flowcharts, and the likerepresent conceptual views or processes illustrating systems and methodsembodying this invention. The functions of the various elements shown inthe figures may be provided through the use of dedicated hardware aswell as hardware capable of executing associated software. Similarly,any switches shown in the figures are conceptual only. Their functionmay be carried out through the operation of program logic, throughdedicated logic, through the interaction of program control anddedicated logic, or even manually, the particular technique beingselectable by the entity implementing this invention. Those of ordinaryskill in the art further understand that the exemplary hardware,software, processes, methods, and/or operating systems described hereinare for illustrative purposes and, thus, are not intended to be limitedto any particular named manufacturer.

Referring now to FIG. 1, a virtual physician office (VPO) 100 typicallyincludes a physician's or physicians' office 110, a home office of aphysician 120, other related client, vendor, and service-orientedparticipants 130 of a multi-institutional partnership (including thephysicians' office) and of non-participants 140 that leverage the assetsof a network-based communications network. The purpose of the VPO 100 isto efficiently share information over a variety of communicationsdevices, automate business and transactional processes, and enhancemarket position. In the case of a VPO, participants 110, 120, 130 andnon-participants 140 may include local hospitals, insurance companies,HMOs, affiliated hospitals, clinics, affiliated physicians' offices,medical schools, universities, and strategic partners. Patients, as wellas vendors, could also be included, as could service providers, such asclinical laboratories, pharmacy services, temporary agencies, privateambulance services, and subspecialty services. After all, rapidcommunication and exchange of information between these entities (e.g.,participants including the doctor's office and includingnon-participants) can make a critical difference in the quality ofpatient care. In most cases, each participant usually has its own legacysystem, including software, hardware, equipment, networks, and/or otherinformation technology assets. For example, a large physicians' officecommonly has a local and/or a wide area network that utilizes Ethernet,dedicated private lines, Frame Relay, ISDN, ATM, ADSL, and the like.Further, these legacy systems provide an interface to the communicationsnetwork 150, such as, for example, a data network, such as the Internet,Intranet, and/or Extranet, that may be locally or remotely accessed by aparticipant's user (e.g., an employee using a computer system within thephysician office legacy system).

This invention provides an efficient networked-based physician practicemanagement application that leverages the assets of each legacy system.The VPO 100 provides improved access, sharing, notification, routing,security, and/or management of electronic healthcare communicationsand/or data associated with the physician practice managementapplication. Typically, the electronic healthcare communication and/ordata contains fields, files, or other electronic indexing thatcross-references multiple agents (e.g., Access Agent, Security Agent,Messaging Agent, Transaction Agent, Troubleshooting Agent, andApplication Agent) of a rule-based application dataserver. This indexingas well as other information that may be gathered from the incomingcommunication signal (e.g., ICLID) and/or interactive information inputby the sender of the communication are used to associate thecommunications and/or data. As discussed in more detail below, thecommunications network 150 uses a rule-based application dataserverpreferably provided by a telecommunications service provider, and alsouses an integrated delivery system (IDS) to process exchanged healthcareinformation into a selected legacy system and/or to present theelectronic healthcare communication (including associated data) to acommunications device. As used herein, the term “electronic healthcarecommunication” includes audio, video, text, and/or digitalcommunications including electronic healthcare communications such asemail, attached files (e.g., an attached file to the email), andcompatible data formats (e.g., a file that has been processed by therule-based application dataserver and the IDS to format and/orstandardize electronic information shared between legacy systems and/orbetween the network-based communications system and a communicationsdevice). The term “electronic healthcare communication” also includestransaction notifications and/or transaction replies generated by therule-based application dataserver and/or the IDS, and/or other means ofcommunicating electronic information between or among participants andnon-participants. Also, as used herein, the term “communications device”includes electronic devices that may be used to communicate audio,video, text, and/or digital communications, such as a personal (PC)computer system, plain old telephone (POTS) phone, a wirelesscommunications device, a mobile phone, a cellular phone, a wide areaprotocol (WAP) phone, a satellite phone, a modem, a pager, a digitalmusic device, a digital recording device, a personal digital assistant(PDA), an interactive television, a digital signal processor (DSP), aGlobal Positioning System (GPS) device, and combinations thereof.Typically, a telecommunications service provider (e.g., local serviceprovider, long distance service provider, wireless service provider)provides telecommunications service to the communications device and,thus, is associated with the communications device.

FIG. 2 is a block diagram showing a VPO Management Module 210 residingin a computer system 200. The VPO Management Module 210 operates withina system memory device. The VPO Management Module 210, for example, isshown residing in a memory subsystem 212. The VPO Management Module 210,however, could also reside in flash memory 214 and/or in a peripheralstorage device, such as storage device 240. The computer system 200 alsohas one or more central processors 220 executing an operating system.The operating system, as is well known, has a set of instructions thatcontrol the internal functions of the computer system 200. A system bus222 communicates signals, such as data signals, control signals, andaddress signals, between the central processors 220 and a systemcontroller 224 (typically called a “Northbridge”). The system controller224 provides a bridging function between the one or more centralprocessors 220, a graphics subsystem 226, the memory subsystem 212, anda PCI (Peripheral Controller Interface) bus 228. The PCI bus 228 iscontrolled by a Peripheral Bus Controller 230. The Peripheral BusController 230 (typically called a “Southbridge”) is an integratedcircuit that serves as an input/output hub for various peripheral ports.These peripheral ports could include, for example, a keyboard port 232,a mouse port 234, a serial port 236 and/or a parallel port 238.Additionally, these peripheral ports would allow the computer system 200to communicate with a variety of communications devices through ports(such as a SCSI port and/or an Ethernet port, shown as reference numeral254), a Wireless Transceiver port 252 (using the IEEE Wireless standard802.11, Infrared, the Industrial and Scientific band of theelectromagnetic spectrum, or any other portion of that same spectrum),and a Wired Comm Device Port 250 (such as modem V90+ and compact flashslots). The Peripheral Bus Controller 230 could also include an audiosubsystem 235. Additionally, the computer system 200 may interface witha network server 244 operating with a network browser 246. The networkserver 244 and the network browser 246 may be stand alone or integratedcomponents. Still further, the computer system 200 may include a powersource 260, such as a rechargeable battery to provide power and allowthe computer system 200 to be portable. The power source 260 mayadditionally or alternatively include an alternating current (AC) powersource or power converter.

The processor 220 is typically a microprocessor. Advanced Micro Devices,Inc., for example, manufactures a full line of microprocessors, such asthe ATHLON™ (ATHLON™ is a trademark of Advanced Micro Devices, Inc., OneAMD Place, P.O. Box 3453, Sunnyvale, Calif. 94088-3453, 408.732.2400,800.538.8450, www.amd.com). Sun Microsystems also designs andmanufactures microprocessors (Sun Microsystems, Inc., 901 San AntonioRoad, Palo Alto Calif. 94303, www.sun.com). The Intel Corporationmanufactures microprocessors (Intel Corporation, 2200 Mission CollegeBlvd., Santa Clara, Calif. 95052-8119, 408.765.8080, www.intel.com).Other manufacturers also offer microprocessors. Such other manufacturersinclude Motorola, Inc. (1303 East Algonquin Road, P.O. Box A3309Schaumburg, Ill. 60196, www.Motorola.com), International BusinessMachines Corp. (New Orchard Road, Annonk, N.Y. 10504, (914) 499-1900,www.ibm.com), and Transmeta Corp. (3940 Freedom Circle, Santa Clara,Calif. 95054, www.transmeta.com).

The preferred operating system is the UNIX® operating system (UNIX® is aregistered trademark of the Open Source Group, www.opensource.org).Other UNIX-based operating systems, however, are also suitable, such asLINUX® or a RED HAT® LINUX-based system (LINUX® is a registeredtrademark of Linus Torvalds, and RED HAT® is a registered trademark ofRed Hat, Inc., Research Triangle Park, N.C., 1-888-733-4281,www.redhat.com). Other operating systems, however, are also suitable.Such other operating systems would include a WINDOWS-based operatingsystem (WINDOWS® is a registered trademark of Microsoft Corporation, OneMicrosoft Way, Redmond Wash. 98052-6399, 425.882.8080,www.Microsoft.com). and Mac® OS (Mac® is a registered trademark of AppleComputer, Inc., 1 Infinite Loop, Cupertino, Calif. 95014, 408.996.1010,www.apple.com).

The system memory device (shown as memory subsystem 212, flash memory214, or peripheral storage device 240) may also contain one or moreapplication programs. For example, an application program may cooperatewith the operating system and with a video display unit (via the serialport 236 and/or the parallel port 238) to provide a Graphical UserInterface (GUI) display for the VPO Management Module 210. The GUTtypically includes a combination of signals communicated along thekeyboard port 232 and the mouse port 234. The GUI provides a convenientvisual and/or audible interface with the user of the computer system200. As is apparent to those of ordinary skill in the art, the selectionand arrangement of the VPO Management Module 210 may he programmed overa variety of alternate mediums, such as, for example, a voice-activatedmenu prompt.

The VPO Management Module 210 allows the physicians' office 110 (and/orphysician home 120) to manage VPO services, such as: (1) allowing a user(e.g., an authorized staff member associated with the physician officelegacy system) to customize rules and user groups associated with eachpractice management application including the physician practicemanagement application; (2) allowing the user to customize rules anduser groups associated with a rule-based engine of the rule-baseddataserver; (3) allowing the user to customize presentation, features,and/or management of an incoming electronic healthcare communication(e.g., an email, an attached file, a compatible second data format, atransaction reply, a transaction notification, and/or other electroniccommunications); and (4) allowing the user to control routing andintegration of the electronic healthcare communication within andbetween the physician office legacy system, other legacy systems, andnon-participant communications device. For example, the user may selectan Access Agent having a user group list to add, delete, or modifyphysician office staff information, such as, associated service nodeaddresses, IP addresses, email addresses, and/or other electronicaddress information of communications devices associated with thephysicians' office legacy system (e.g., the phone number of thecommunications device, such as a doctor's cell phone number, is inputinto a communications profile to identify the communications device withthe physicians' office legacy system). For example, an address of theuser group list may be associated with the electronic healthcarecommunication and act as a trigger (similar to decoding an ICLID signalfor telecommunication special service features offered bytelecommunication service providers) to automatically send theelectronic healthcare communication to the VPO rule-based applicationdataserver and to automatically open one or more of the network-basedpractice management applications with the communication. The VPOManagement Module 210 also allows the user to customize features, suchas electronic healthcare communication handling options. For example,the VPO Management Module 210 may split a user's screen into two viewingareas and present the incoming electronic healthcare communication inone portion and present the physician practice management application inthe second portion. Further, the VPO Management Module 210 may allow theuser to control whether to accept, decline, or postpone integration of acompatible data format into the physician office legacy system (or alegacy system of another participant or a communications device of anon-participant) or might be set to automatically accept, decline, orpostpone integration depending on a participant's address or on anaddress of the non-participant's communications device. Still further,the VPO Management Module 210 of the computer system 200 may provide theIP address or the like so that the communications network 150 cancommunicate the electronic healthcare communication, and, thus integratetelephony events and data network events with the legacy system and/orthe non-participant's communications device. Further, the VPO ManagementModule 210 may interact and/or otherwise interface with atelecommunications network-based information systems (NBIS) managementmodule that controls access, sharing, notification, security, and/ormanagement of electronic healthcare data exchanged between or amongdifferent legacy systems of participants. The NBIS Management Module andrelated methods and systems are disclosed in applicants' co-pending U.S.patent application Ser. No. 10/253,500 entitled “Network-BasedHealthcare Information Systems,” (Attorney Docket 02-BS017/BS00233)filed Sep. 24, 2002, and of which the “Brief Summary of the Invention”and “Detailed Description of the Invention” sections are incorporatedherein by this reference. Still further, the VPO Management Module 210may interact and/or otherwise interface with a healthcare VirtualPrivate Network (VPN) Management Module that controls access, sharing,notification, security, and/or management of electronic healthcare dataexchanged between or among different legacy systems and communicationsdevices of non-participants. The VPN Management Module and relatedmethods and systems are disclosed in applicants' co-pending U.S. patentapplication entitled “Healthcare Virtual Private Network Methods andSystems,” (Attorney Docket 02-BS061/BS02524) filed simultaneouslyherewith, and of which the “Brief Summary of the Invention” and“Detailed Description of the Invention” sections are incorporated hereinby this reference.

The VPO Management Module 210 further allows the physicians' office 110to control access, sharing, notification, routing, security, management,and/or additional processing of electronic healthcare communicationswithin an application (such as practice management application 430 ofFIG. 4). Typically, the application is hosted by the communicationsnetwork 150 via e-center 315. Thus, the VPO 100 allows the applicationto be customized to share electronic healthcare communications with avariety of communications devices of the physicians' office legacysystem, other legacy systems, and non-participants. In addition, the VPOManagement Module 210 may allow the physicians' office (via anauthorized user/staff member) 110 to control how the data (i.e., theelectronic healthcare communication and/or associated data) is furtherprocessed by the application including (1) sending the data to a localstorage device (such as database 240 of FIG. 2), or alternatively, to aremote storage device (such as affiliated data center 130 or e-center315 of FIG. 3), (2) instructions for archiving the data (e.g., datacompression, duration of storage, etc.), (3) encrypting the data, (4)copying the data, and (5) associating the data with a VPO rule-basedprofile (such as VPO rule-based profile 500 of FIG. 5). The VPOManagement Module 210 may be downloaded from a telecommunicationsnetwork, a data network, or provided on a storage media (e.g., diskette,CD-ROM, or installed by the computer system manufacturer) to install onthe computer system 200 to enable, disable, and further control avariety of VPO services.

Referring to FIGS. 3-8, the VPO 300 includes a legacy system associatedwith the physicians' office 110 and/or physicians' home 120, at leastone legacy system of other participants (e.g., affiliated hospital,affiliated lab, and/or affiliated data center) 130, at least onecommunications device (and/or information system) of a non-participant(e.g., insurer and/or payer) 140, a first central office 310 connectedwith the physicians' office 110 and/or home 120, fast packet portal 312,switched packet portal 314, an electronic center (“e-center) 315, a datanetwork 320, and a second central office 330 connected with otherparticipants 130. Communications devices of the legacy systems (e.g.,legacy systems of participants 110, 120, 130) and of thenon-participants are not shown in FIG. 3; however, specific exemplarycommunications devices are shown in FIGS. 7-8 and include computer 200,personal digital assistant (PDA) 702, wireless phone 704, modem 706,interactive pager 708, global positioning system (GPS) 710, MP3 712,digital signal processor 714, and interactive television 716. Eachphysicians' office legacy system typically includes at least onecomputer system 200 and may have the VPO Management Module 210(including the IP address or other communications address associatedwith the physicians' office connection to a telecommunications network,data network connection, and/or communications network) residing withinthe computer system 200. Turning now to FIG. 4, the first central office310 connected with the physicians' office legacy system and the secondcentral office 330 of the other participants may include a serviceswitching point (SSP) (not shown), a service control point (SCP) (notshown), an Intranet (not shown), and a VPO Rule-Based ApplicationDataserver 420. Switch 415 allows the connected physicians' officelegacy system 110, home 120, other participants' legacy systems 130, andcommunications devices of non-participants to communicate electronichealthcare communications 410 via the communications network 150.Similarly, each switch 415 allows a connected communications device tocommunicate electronic healthcare communications 410 via thecommunications network facility 150. In a preferred embodiment, thecommunications network facility is a telecommunications networkfacility. The telecommunications network facility may include thecentral office (CO) (310, 330 of FIG. 3) a mobile telephone switchingoffice (MTSO) (not shown), and/or a combination CO/MTSO. Further, thecommunications network facility 150 may use any means of couplingswitches 415 to the facility 440, but the coupling means is preferablyhigh-capacity, high-bandwidth optical transport services, GigabitEthernet services, and/or the like for digital electronic healthcarecommunications, such as fast packet portal 312. Other coupling meansincludes switch network portal 314 typically used for voice and datatransmissions. As those of ordinary skill in the art of communicationsunderstand, the telecommunications network facility could also linkswitches 415 of the legacy system (or the communications device of thenon-participant) via other appropriate means, such as, for example aSynchronous Optical Network (SONET) structure with redundant, multiplerings. In addition, the telecommunications network facility, legacysystems, communications network, and communications devices may beconnected by similar slower lines, such as copper conductors, digitalsubscriber lines, and the like.

Typically, a user (e.g., staff member of physicians' office) usescomputer system 200 to gain access to the communications network 150.For example, if the user wishes to use one or more of the applications430 and/or send, receive, or access voice, video, and/or data (e.g.,read and respond to e-mail, order test results, view video-clipsincluding static images, listen to recorded information, engage in aninteractive-diagnosis session, etc.), then the computer system 200connects with the communications network 150 via switch 415.Alternatively, the computer system 200 may have a dedicated line anddirectly connect with the communications network. Communications signalsassociated with the electronic healthcare communication 410 arrive atthe communications network 150 and are associated (either by input fromthe user or by the dataserver) with the physicians' office legacy system110. The VPO 400 may include wired, optical, and/or wireless elementsand may further include private network elements, such as private branchexchanges (PBXs), and/or other elements (not shown). The communicationsnetwork 150 includes Advanced Intelligent Network (AIN) componentrycontrolling many features of the network. The communications network 150and/or switches 415 could also include a packet-based “soft switch” thatuses software control to provide voice, video, and/or data services bydynamically changing its connection data rates and protocols types. Ifthe communications network 150 or switches 415 should include asoftswitch, the AIN componentry is replaced by an application serverthat interfaces with the softswitch via a packet protocol, such asSession Initiation Protocol (SIP). The signaling between the computersystem 200, the legacy systems 110, 120, 130, the communications deviceof non-participants 140, the switches 415, the communications network150 including AIN componentry, data network 320, central offices 310,320 and the e-center 315, however, are well understood in by those ofordinary skill the art and will not be further described. Further, thoseof ordinary skill in the art will be able to apply the principles ofthis invention to their own information and computing systems includingtheir network configurations which may differ substantially from thesystem shown in the figures.

The VPO Rule-Based Application DataServer 420 allows the physicians'office to activate, de-activate, administer, and/or otherwise managee-center 315 services including data storage and backup, network-basedapplications 430, integrated delivery systems 440, and hosting services.In an embodiment, the VPO Rule-Based Application DataServer 420 has theability to communicate with various networks, including internal andexternal telecommunications and/or data networks using appropriateprotocols, such as standard transmission control protocol and Internetprotocol (TCP/IP). The VPO Management Module 210 may be downloaded froman internet service provider (e.g., America On Line (AOL)), the VPORule-Based Application DataServer 420, the central offices 310 and 330,and the data network 320. The VPO Management Module may also be providedon a storage media (e.g., diskette, CD-ROM, and/or DVD) or installed bythe computer system manufacturer. However the VPO Management Module 210is obtained, the VPO Management Module 210 is delivered to thephysicians' office 110 and installed on the computer system 200 toenable, disable, and further control a variety of the VPO ManagementServices. Additionally, the non-participant 140 is typically provided anapplet and/or a web browser interface for communicating the electronichealthcare communication over the VPO. The applet and/or web-browseroperates over the non-participant's communication device to allow thenon-participant to control a limited set of commands for VPO ManagementServices including verification and authentication requirements.

As illustrated by FIG. 4, the flow of the electronic healthcarecommunication 410 may involve the physicians' office 110 using computersystem 200 to create the electronic healthcare communication 410 with orwithout an attached file and/or associated data. The physicians' office110 may create the electronic healthcare communication 410 using avariety of software applications including electronic messaging, wordprocessing, and others (e.g., MICROSOFT OUTLOOK® and MICROSOFT WORD®,both registered trademarks of Microsoft Corporation, One Microsoft Way,Redmond Wash. 98052-6399, 425.882.8080, www.Microsoft.com). In anembodiment, the electronic healthcare communication 410 is created byconnecting to and accessing the communications network 150 and using thenetwork-based practice management software application 430 (typicallyprovided by a participant application service provider (ASP)). In apreferred embodiment, the network-based application 430 is a physicianpractice management application providing management of at least one ofthe following for the physicians' office: (1) a calendar and schedule ofphysicians and staff including work schedules, appointments, meetings,facilities used for appointments and meetings, and other relatedinformation, (2) patient information including medical records andreleases, contact information, insurer information, and scheduledappointments, (3) charges and fees for billing insurers and other payers(e.g., patient, employer, guardian, etc.), (4) receipts for servicesprovided by the physician office and products purchased by the physicianoffice, (5) laboratory testing including laboratory contact information,work schedule, requirements for lab specimens, fees and charges, andother information, (6) prescriptions including a drug information,pharmacy contact information, new research for drugs on the market anddrugs not yet on the market, and other related information, (7) reports,(8) office facilities and maintenance including facility administrationsuch as loans for equipment, rental information, cleaning services, andother information, (9) compliance and inspections for federal, state,and local regulations governing the physician practice, (10) patienttriage and medical protocols, (11) on-call services including schedulesof physicians and staff responsible for handling call, contact numbers,and contact information for hospitals that will admit patients(including hospitalists to admit the patient, if necessary), (12)insurance appeals for processing insurance claims that are returned,(13) billing and financial management services including patientbilling, payroll, building rent, equipment rental, and other accounting,and (14) back-up storage settings for redundant storage of theinformation in items (1)-(13). A stand alone, exemplary physicianpractice management application that provides a portion of some of thesemanagement features is HEALTHBILLRX offered by HealthCentrics, OneNorthside 75, Suite 120, Atlanta, Ga. 30318, 404.609.5070,www.healthcentrics.com). The electronic healthcare communication 410 maybe created using an applet, a web browser, and/or the VPO ManagementModule 210 residing on computer system 200 to interact and inputinformation (including the electronic healthcare communication and/orrelated data) with the application 430. Further, the application 430 mayinclude and/or interface with the IDS 440. After the electronichealthcare communication is received by the communications network 150,the VPO Rule-Based DataServer 420 determines whether external datasources (e.g., affiliated data center 130, a database of affiliatedhospital 130, etc.) need to be queried for related electronic healthcaredata or for retrieving a file that is linked rather than attached to theelectronic healthcare communication 410, and, if so, retrieves therelated data. Next, the communications network 150 interprets theelectronic healthcare communication 410 including any attached files,related healthcare data, and/or the linked files using network elementsincluding the VPO Rule-Based Application DataServer 420. Thereafter, theVPO Rule-Based Application DataServer 420 routes the electronichealthcare communication (e.g., the attached file, related healthcaredata, and/or the linked object) 410 to the IDS 440 so that theelectronic healthcare communication 410 may be interpreted forcompatible exchange with a participant's legacy system 110, 120, 130and/or a communications device of a non-participant 140. The IDS 440 maybe a stand alone system (not shown in the figures), the IDS 440 may beintegrated into the communications network 150 (as shown in FIG. 4), theIDS 440 may be integrated with one of the participant's legacy systems(not shown in the figures) that is accessed by the communicationsnetwork 150 or data network 320, or the IDS 440 may be a combination ofthese systems (not shown). No matter how the IDS 440 is deployed, theelectronic healthcare communication 410 and/or data is received,processed so that the electronic healthcare communication 410 and/ordata are compatible for the receiving legacy system 110, 120, 130 and/orcommunications device of the non-participant, and associated with atransaction reply (e.g., a communication to the communications device ofa party receiving the electronic healthcare communication 410 includinginformation about the attached file or the compatible data format) orwith a transaction notification (e.g., a communication to thecommunications device of a sending party (e.g., party originating,creating, forwarding, or otherwise sending the communication) about theelectronic healthcare communication 410 including information about theattached file or the compatible data format). Thereafter, thetransaction reply and/or the transaction notification are routed throughthe communications network 150 and forwarded to the receiving legacysystem or to the non-participant's communications device (not shown).The VPO Management Module 210 (or, alternatively, the practicemanagement application 430 via an interface with the VPO ManagementModule 210) presents the electronic healthcare communication 410 so thatthe receiving physicians' office 110 of the computer system 200 hasimmediate access, notification, and management of the electronichealthcare communication 410 including the compatible data format andupdated data in a receiving legacy system 110, 120, 130 and/orcommunications device of a non-participant 140.

Referring now to FIG. 5, the physicians' office 110 interacts with theVPO Management Module 210 to access and login to the VPO Rule-BasedApplication DataServer 420 and to establish a VPO Rule-Based Profile500. The VPO Rule-Based Application DataServer 420 stores one or moreVPO Rule-Based Profiles 500 that include data and applicationsassociated with an Access Agent 511, a Security Agent 512, aMessaging/Communications Agent 513, a Transaction Agent 514, aTroubleshooting Agent 515, and an Application Agent 516. For example,the Access Agent 511, Security Agent 512, Messaging/Communications Agent313, Transaction Agent 514, Troubleshooting Agent 515, and ApplicationAgent 516 may contain a variety of fields and/or files associated withat least one of the following: login information associated with a user(including participants 110, 120, 130, non-participants 130, and/orauthorized users), password of the user, telephone number or ServiceNode of the user (this may include a plurality of addresses that areassociated with a Service Node or other switch, such as, for example,switch 415 serving the legacy systems 110, 120, 130), TCP/IP address ofthe user, profile of the computer system 200 or other communicationsdevice associated with the incoming electronic healthcare communication(e.g., presentation formats for various communications devices), a timeor date identifier (e.g., day of week or calendar date), otherinformation associated with the electronic healthcare communicationssignal, size and content of electronic healthcare communication(including types of files that are transmitted as an attached file),transaction reply(s), transaction notification(s), display of a GUI(e.g., color, font, placement of VPO Management Module 210 on screen,etc.), associations with network-based applications, VPO ManagementService defaults (e.g., whether the IDS automatically re-formats theattached file to a compatible data format and updates the legacy systemwith the compatible data format), and other selections related to VPOManagement Services, such as electronic healthcare communicationfeatures, electronic healthcare communication routing, andtroubleshooting problems or error messages.

FIG. 6 illustrates an embodiment of establishing a physicians' officelegacy VPO Rule-Based Profile 600 to interact with the VPO Rule-BasedProfile 500 of the communications network 210. The VPO Management Module210 of computer system 200 is used to establish, store, and manage thelegacy VPO Rule-Based Profile 600 for legacy system 110 (i.e., thehospital's legacy system). The legacy system 110 stores one or more ofthe VPO Rule-Based Profiles 600 that include data and applicationssimilar to VPO Rule-Based Profile 500. The legacy VPO Rule-BasedProfiles 600, however, provide increased security by allowing thephysicians' office 110 to internally control electronic healthcare dataand/or communications, utilize existing databases to add, delete, orotherwise change electronic healthcare data and/or communications,control how the physicians' office legacy system 110 (or home legacysystem 120) interacts with the practice management application 430and/or IDS 440, and control routing instructions within its legacysystem 110.

FIGS. 7-8 are schematics showing a variety of wired and wirelesscommunications devices communicating the electronic healthcarecommunication 410 through the communications network 150 according toalternate embodiments of this invention. The means of coupling thecomputer system 200 or other communications devices (shown as referencenumerals 702-718) to switch 415 includes optical transmission ofelectronic healthcare data, wireless transmission of electronichealthcare data, and/or fixed-wire transmission of electronic healthcaredata (e.g., via a local loop of a telecommunications network tocommunicate electronic healthcare data). Fiber optic technologies,spectrum multiplexing (such as Dense Wave Division Multiplexing),Ethernet and Gigabit Ethernet services, and Digital Subscriber Lines(DSL), and copper conductors are just some examples of the couplingmeans.

FIG. 7 illustrates a VPO 700 similar to the VPO 300 of FIG. 3. VPO 700,however, illustrates specific communications devices that may be used bythe participant 130 (or, alternatively physicians' office 110 and/orhome 120 although not shown) and/or the non-participant 140. VPO 700includes alternate communications devices that include a personaldigital assistant (PDA) 702, a mobile phone 704 (e.g., cellular,satellite, Internet Protocol), a modem 706, an interactive pager 708, aglobal positioning system (GPS) transceiver 710, an MP3 player 712, adigital signal processor (DSP) 714, and an interactive television 716.These alternate communications devices communicate via an antenna 720communicating with an MTSO 730 that communicates the electronichealthcare communication 410 to the switch 415. Whether thecommunications devices or the computer system 200 is used, switch 415routes the electronic healthcare communication 410 to the communicationsnetwork 150. In addition, FIG. 7 illustrates that the computer system ofthe physicians' office legacy system 110 includes a variety ofcommunications devices including computer system 200 and wirelesscommunications device, such as PDA 702 (as well as other wirelesscommunications devices, such as reference numerals 704-716). Regardlessof the communications device used to send the electronic healthcarecommunication 410, the electronic healthcare communication 410 may needto be formatted accordingly for the receiving communications device(including audio, text (e.g., ASCII), video, other digital formats, andcombination thereof). Thus, the VPO Rule-Based Application DataServer420 has the intelligence to associate the presentation capabilities ofthe alternate communications device (associated with participants andnon-participants).

FIG. 8 illustrates a VPO 800 similar to the VPO 700 disclosed in FIG. 7.This VPO 800, however, includes a communications device gateway 810connected with a data network 820 and a communications server 830 sothat the electronic healthcare communication 410 communicated to/fromswitch 415 may be appropriately formatted for presentation on alternatecommunications devices (such as those shown and described with referencenumerals 702-716). For example, if the alternate communications deviceuses the Wireless Application Protocol (WAP) technique, then theelectronic healthcare communication (including transaction repliesand/or notifications) 410 is communicated to the communications (“Comm”)server 830. The electronic healthcare communications server 830 formatsthe electronic healthcare communication 410 into one or more WirelessMark-up Language (WML) messages that are communicated over the datanetwork 820 to the communications device gateway 810. The communicationsdevice gateway 810 then interfaces with the MTSO 730, and the MTSO 730then wirelessly communicates the electronic healthcare communication 410to the communications devices. The Wireless Mark-up Language (WML) andthe WAP technique are known and will not be further described. This is adescription of a solution for a specific wireless protocol, such as WAP.This solution may be clearly extended to other wireless protocol, suchas i-mode, VoiceXML (Voice eXtensible Markup Language), and othersignaling means.

FIGS. 9-11 are flowcharts showing a process of providing the virtualphysician office (VPO) services according to an embodiment of thisinvention. While the process in FIGS. 9-11 is shown in series, theseprocesses may occur in different orders and/or at simultaneous times asone of ordinary skill in the art will understand.

Referring now to FIG. 9, a network-based communications system receivesan electronic healthcare communication (“e-health comm”) associated witha physician office legacy system (block 900). The network-basedcommunications system categorizes the electronic healthcarecommunication using a rule-based application dataserver to categorizeand associate rule based agents, fields, and/or files (block 910).Accordingly, the dataserver may associate the electronic healthcarecommunication with an access agent (block 920), a security agent (block930), a messaging agent (block 940), a transactional agent (block 950),a troubleshooting agent (block 960), and an application agent (970)(e.g., a practice management agent for providing physician officemanagement services). Thereafter, the access agent authenticates theuser (block 925). The security agent ensures security requirementsassociated with the physician office legacy system, home system, otherlegacy systems, and communications devices of non-participants (block935). The messaging agent may interface with a contact center, such asfor example, the dynamic contact center disclosed in applicants'co-pending U.S. patent application Ser. No. 10/335,113 entitled“Computer Telephony Integration (CTI) Complete Customer Contact Center,”(Attorney Docket 02-BS059/BS02529) filed Dec. 31, 2002 (block 945). Thetroubleshooting agent provides online help and support as well ascontact (via electronic correspondence, voice, and/or video) withcustomer relations and technical support staff (not shown). Theapplication agent accesses and uses the physician management applicationto manage at least one of the following: (i) a calendar and schedule,(ii) patient information, (iii) charges and fees, (iv) receipts, (v)laboratory testing, (vi) prescriptions, (vii) reports, (viii) officefacilities and maintenance, (ix) compliance and inspections, (x) patienttriage and medical protocols, (xi) on-call services, (xii) insuranceappeals, (xiii) patient billing, and (xiv) back-up storage settings(block 975).

The flowchart continues with FIG. 10. The method determines whether anintegrated delivery system (IDS) is a component of the network-basedcommunications system. If “no,” then the network-based communicationssystem routes the electronic healthcare communication to the IDS of alegacy system (block 1010) and the IDS processes the electronichealthcare communication (block 1020). If the IDS is a component of thenetwork-based communications system, then the network basedcommunications system processes the electronic healthcare communication(block 1030). Thereafter, a rule-based engine associated with thedataserver determines whether to activate a transaction reply and/ortransaction notification (block 1040). If “no,” then the electronichealthcare communication is processed according to the rule-based engine(block 1050). However, if the transaction reply and/or notification isactivated (block 1040), then the method continues with FIG. 11. Thenetwork-based communications system receives the transaction replyand/or notification (block 1100). The IDS then processes the electronichealthcare data to a compatible data format for the receivingcommunication (e.g., computer system 200 of physicians' office legacysystem 110) (block 1110). Thereafter, the network-based communicationssystem may further process the compatible data format by sorting,encrypting, managing, and/or associating other related data (block1120). Next, the transaction replay and/or notification is routed to anassociated computer system and/or communications device (block 1130).Finally, the computer system and/or communications device presents thetransaction reply and/or notification (block 1140).

While several exemplary implementations of embodiments of this inventionare described herein, various modifications and alternate embodimentswill occur to those of ordinary skill in the art. Accordingly, thisinvention is intended to include those other variations, modifications,and alternate embodiments that adhere to the spirit and scope of thisinvention.

1. A method, comprising: receiving, at a server, an electronic databaserecord, the electronic database record in a legacy format that isdestined for delivery to device identified by a recipient address;comparing, by the server, the recipient address to a list of addresses;determining, by the server, a match between the recipient address andone of the addresses; reformatting, by the server, the electronicdatabase record from the legacy format into a reformatted databaserecord compatible with a different format associated with the recipientaddress; and sending, from the server, the reformatted database recordto the recipient address.
 2. The method of claim 1, further comprisingexecuting a rule associated with the recipient address.
 3. The method ofclaim 1, further comprising executing a rule associated with thedifferent format.
 4. The method of claim 1, further comprisingcategorizing the electronic database record.
 5. The method of claim 1,further comprising associating the legacy format to a software agentthat reformats the electronic database record.
 6. The method of claim 1,further comprising encrypting the reformatted database record.
 7. Themethod of claim 1, further comprising associating the recipient addresswith a profile.
 8. A system, comprising: a processor; and a memorystoring code that when executed causes the processor to performoperations, the operations comprising: receiving an electronic databaserecord, the electronic database record in a legacy format that isdestined for delivery to device identified by a recipient address;comparing the recipient address to a list of addresses; determining amatch between the recipient address and one of the addresses;reformatting the electronic database record from the legacy format intoa reformatted database record compatible with a different formatassociated with the recipient address; and sending the reformatteddatabase record to the recipient address.
 9. The system of claim 8,wherein the operations further comprise executing a rule associated withthe recipient address.
 10. The system of claim 8, wherein the operationsfurther comprise executing a rule associated with the different format.11. The system of claim 8, wherein the operations further comprisecategorizing the electronic database record.
 12. The system of claim 8,wherein the operations further comprise associating the legacy format toa software agent that reformats the electronic database record.
 13. Thesystem of claim 8, wherein the operations further comprise encryptingthe reformatted database record.
 14. The system of claim 8, wherein theoperations further comprise associating the recipient address with aprofile.
 15. A memory storing code that when executed causes a processorto perform operations, the operations comprising: receiving anelectronic database record, the electronic database record in a legacyformat that is destined for delivery to device identified by a recipientaddress; comparing the recipient address to a list of addresses;determining a match between the recipient address and one of theaddresses; reformatting the electronic database record from the legacyformat into a reformatted database record compatible with a differentformat associated with the recipient address; and sending thereformatted database record to the recipient address.
 16. The memory ofclaim 15, wherein the operations further comprise executing a ruleassociated with the recipient address.
 17. The memory of claim 15,wherein the operations further comprise executing a rule associated withthe different format.
 18. The memory of claim 15, wherein the operationsfurther comprise categorizing the electronic database record.
 19. Thememory of claim 15, wherein the operations further comprise associatingthe legacy format to a software agent that reformats the electronicdatabase record.
 20. The memory of claim 15, wherein the operationsfurther comprise encrypting the reformatted database record.